芯针穿刺活检对骨与软组织恶性肿瘤效用的对比

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摘要目的研究芯针穿刺活检在骨与软组织恶性肿瘤中的诊断准确率，并分析其影响因素。方法回顾性分析海军军医大学第一附属医院骨科2014年1月至2021年9月收治的302例骨与软组织恶性肿瘤患者的病例资料。其中，恶性骨肿瘤118例，男62例，女56例；年龄12~79岁，中位年龄49岁。软组织肉瘤184例，男79例，女105例；年龄范围8~83岁，中位年龄52岁。对比芯针穿刺活检与根治性手术后的病理结果，评估准确率，分析影响准确率的因素。结果病理诊断准确率，原发恶性骨肿瘤为89.8%(106/118)，软组织肉瘤为72.3%(133/184)，差异有统计学意义(P＜0.001)。分级诊断准确率，原发恶性骨肿瘤为84.0%(21/25)，软组织肉瘤为56.4%(22/39)，差异有统计学意义(P＝0.022)。芯针穿刺活检容易将高级别肿瘤误诊为低级别肿瘤。肿瘤坏死区域大，可能降低诊断准确率。结论芯针穿刺活检对于原发性恶性骨肿瘤具有很高的准确性，但对于软组织肉瘤的诊断准确性仍然有限。

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	刘畅
	汪淼
	陈峒江
	连邱健
	李博
	林楷丰
	乔苏迟
	韩雪松
	王志伟

关键词 ：芯针穿刺活检, 恶性骨肿瘤, 肉瘤, 诊断准确性

Abstract：Objective To investigate the diagnostic accuracy of core needle biopsy in bone and soft tissue malignant tumors and analyze the influencing factors.Methods The data of 302 patients with bone and soft tissue malignancies treated in the Department of Orthopeadics of the First Affiliated Hospital of Naval Medical University from January 2014 to September 2021 were retrospectively analyzed.There were 118 cases of malignant bone tumors and 184 cases of soft tissue sarcoma.Among the patients with malignant bone tumors，there were 62 males and 56 females，with an age range of 12 to 79 years and a median age of 49 years.Among the patients with soft tissue sarcoma，there were 79 males and 105 females，with an age range of 8 to 83 years and a median age of 52 years.The pathological results between core needle biopsy and radical surgery were compared.The accuracy of core needle biopsy was evaluated.The factors that affected the accuracy were analyzed.Results The accuracy of pathological diagnosis was 89.8%(106/118) for primary malignant bone tumors and 72.3%(133/184) for soft tissue sarcomas.The difference was statistically significant (P＜0.001).The accuracy of graded diagnosis was 84.0%(21/25) for primary malignant bone tumors and 56.4%(22/39) for soft tissue sarcomas.The difference was statistically significant (P＝0.022).Core needle biopsy tended to misdiagnose high-grade tumors as low-grade tumors.The large necrosis area in the tumor might be related to the decrease in diagnostic accuracy.Conclusion The accuracy of core needle biopsy is high for primary malignant bone tumors and limited for soft tissue sarcomas.

Key words： core needle biopsy malignant bone neoplasms sarcoma diagnostic accuracy

基金资助:国家自然科学基金项目(82171383)
海军军医大学第一附属医院“234学科攀峰计划”资助项目(2019YXK055)
福建省自然科学基金资助项目(2019J01519)

通讯作者: 王志伟

作者简介: 刘畅(1987－ )，男，主治医师，海军军医大学第一附属医院骨科，fluency1987@163.com

引用本文:

刘畅，汪淼，陈峒江，连邱健，李博，林楷丰，乔苏迟，韩雪松，王志伟. 芯针穿刺活检对骨与软组织恶性肿瘤效用的对比[J]. 实用骨科杂志, 2022, 28(09): 793-.
Liu Chang，Wang Miao，Chen Tongjian，Lian Qiujian，Li Bo，Lin Kaifeng，Qiao Suchi，Han Xuesong，Wang Zhiwei. Comparative Analysis of Clinical Utility of Core Needle Biopsy for Bone and Soft Tissue Malignant Tumors. sygkzz, 2022, 28(09): 793-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2022/V28/I09/793

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